Psychoanalytic Thinking on the Unhoused Mind

Gabrielle Brown, Gabrielle Brown

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429620782
• Edition: 1
• Topic: Psychology
• Subtopic: Psychoanalysis
• Index: Psychology

Psychoanalytic Thinking on the Unhoused Mind illuminates the psychological underpinnings of current societal problems: homelessness, mental distress, loneliness and states of societal breakdown and exclusion. Illustrated with a broad range of clinical work as well as thoughts on art and literature, the book brings to life complex tensions between the individual psyche, the group, and wider political and cultural structures.

'Unhoused' states of mind are explored in rough sleepers, ex-prisoners, survivors of institutional abuse and family trauma, and people living with personality disorder, addiction, psychosis and dementia. Chapters describe outreach, assessment and long-term psychotherapy, as well as reflective practice with staff teams and care systems, and learning from consultation, supervision and policy development. New therapeutic responses to chronic risk and to resilience are developed from psychoanalytic understandings of difficulties with containment and care.

The collection will be of value to psychotherapists and other mental health practitioners, as well as those working in therapeutic, residential and criminal justice settings and outreach services.

Chapter 1

Housing un-housed minds

Complex multiple exclusion and the cycle of rejection revisited

Christopher Scanlon and John Adlam

Introduction

When a country is well governed, poverty and a mean condition are things to be ashamed of. When a country is ill governed, riches and honor are things to be ashamed of.

(Confucius, cited in Legge, 1861)

This chapter is based on the authors’ direct experience of working in a wide range of statutory and non-statutory mental health, social care, housing and criminal justice agencies. These agencies, in their work with the homeless, the dangerous and the disordered, are daily faced with the task and challenge of engagement with people whose essentially antisocial stance is, or is construed to be, one of a refusal to join in. The premise of our argument is that, despite considerable attention being focused from time to time on the problems of the socially excluded, there remains a group of people who appear steadfastly to refuse to be included (see, e.g., Department of Health, 2003; Department for Communities and Local Government, 1999; 2003; 2008; 2009a; 2009b; 2010; 2011; MEAM, 2009, Cornes et al., 2011, McDonagh, 2011). It is our contention that even if the best efforts of our most experienced workers were channelled into addressing these problems – which is rarely actually the case – there would always remain a group of people who will be experienced as refusing to play the game and resisting all efforts to bring them ‘in from the cold’.

We further contend that all mental health and social policy directives that optimistically or cynically envisage a future when all such people will be ‘socially included’ also involve an essentially stubborn and dangerous societal refusal to face up to the reality of these problems. This amounts to a denial of their essential complexity, chronicity and the part that society plays in perpetuating the very problems they seek to alleviate (see, e.g., Jordan, 1996; Young, 1999; UNICEF, 2007; World Health Organisation, 2009; Wilkinson and Pickett, 2009; Dorling, 2010; Cooper and Whyte, 2017). This systemic refusal is dangerous because, no matter how ‘politically correct’ the policy, or how sophisticated the needs assessment tools, such belief systems are setting up socially excluded people, and the workers charged with trying to reach out to them, to fail.

This experience of failure exacerbates a sense of exclusion in the excluded, and increases, sometimes to breaking point, a pervasive sense of disaffection, disappointment and demoralisation in the workers (Cooper and Lousada, 2005; Hopper, 2003; Adlam and Scanlon, 2011b; Adlam et al., 2012; Scanlon, 2017; Adlam et al., 2018). The real problem, therefore, becomes a question of how to relate to the refusal at the heart of these difficulties; how to relate to offensiveness without becoming offended. It is our view that this constitutes one of the major challenges facing all modern mental health, social care, education and criminal justice agencies.

The Diogenes paradigm

In other writing, we have explored the links between homelessness considered as states of mind as well as of body and concepts such as dangerousness and personality disorder (Scanlon and Adlam, 2008; 2011a; 2012; 2013a). We offered, as a paradigm for the societal as well as clinical difficulties inherent in reaching out to difficult-to-reach individuals, the story of Diogenes of Sinope (Navia, 2005; Cutler, 2005), who came into conflict with a shame-full society that sought to shame him and who, in seeking to maintain a relationship with the shamefulness and hypocrisy of that society, chose to ‘hole himself up’ in a barrel in the main square in ancient Athens. We placed at the centre of this paradigmatic story Diogenes’ subsequent encounter with Alexander the Great.

The shame and shaming of Diogenes came as a result of him having been caught debasing the currency of Sinope, which discovery forced him to flee into exile, persona non grata. No longer able to live within his own culture, he became homeless and moved to Athens, where he took up residence in his barrel in the Agora, which was not only the market place for commercial transactions (and the centre for their regulation) but also a place that allowed for philosophical discourse, exchange of ideas and a promise of a meeting of minds: that ‘public/private space where public solutions are sought, negotiated and agreed for private troubles’ (Bauman, 2000, p. 39; see also Adlam and Scanlon, 2013).

The view both of and from Diogenes’ barrel was that he was neither a part of society nor completely apart from it, so he was philosophically and socially in his proper place: that is, the only place available to him. From his barrel, he maintained a questioning and challenging stance towards the society that surrounded him and his protest took the form of a kind of running commentary, through both words and deeds, on the relationships between people and how they were played out in the world. He shared his barrel with dogs – animals that were strongly associated with shamelessness in ancient Greek culture. He became known as ‘Diogenes the Dog’, and from his barrel (or kennel) he would reflect back to the wider society something of their shaming hypocrisy by living the best way he could: by making the best of his un-housed and dis-membered state.

Diogenes came to be known as a Cynic (named after the ancient Greek word kunikos, meaning ‘dog-like’). Cynicism with a capital ‘C’ is not so much a philosophical school as an ethically driven practice or way of being in which virtue is a life lived in accord with nature and a relentless questioning and challenging of the received wisdom of the urban, Metropolitan world of property and civic mores. Diogenes’ Cynicism moved him to refuse accommodation from societal systems that he regarded as fundamentally untruthful and hypocritical: his project was to ‘debase’ the socio-political ‘currency’. This Cynicism was expressed in various ways. For example, when seen carrying around a torch in broad daylight, he explained he was in search of ‘one honest man’. On one occasion, when found masturbating in his barrel, he supposedly said that he ‘wished it were as easy to relieve hunger by rubbing an empty stomach’. On another occasion, asked why he was apparently begging from a statue, he replied that he was ‘practising disappointment’: perhaps a very useful skill for the complex and chronically un-housed population that is the focus of this chapter (Navia, 2005; Cutler, 2005).

Diogenes seemed to understand that it was not his problem if people were offended by him; however, if he was offended by what he saw in the world around him, then this was his problem and his task was to relate to this offensiveness and to manage himself in this relationship as best he could. In this way, Diogenes took up the only position in relation to the world that was open to him; a position that was both criminal and liminal. His was a threshold, borderline existence that was neither in nor out. His Cynical position was necessarily antisocial, and was one that was experienced as inherently dangerous and threatening to the status quo. However, he lived perhaps in more tolerant times, for it is not reported that he became subject to any ancient-world equivalent of an antisocial behaviour order (ASBO), nor that the Metropolis felt so concerned about local house prices as to arrange for him to be forcibly evicted and his barrel fumigated or destroyed. (On the other hand, only a few years earlier, Socrates, the companion of Antisthenes, who was Diogenes’ tutor in the practice of Cynicism, had indeed pestered the Athenians too vigorously for their liking and had been forced to drink the hemlock.)

This powerful combination of social challenging and Cynical enquiry comes most sharply into focus in Diogenes’ encounter with Alexander the Great – the most powerful man in the world at that (or perhaps any) time. A piqued Alexander supposedly sought out Diogenes in his barrel when Diogenes (dangerously) refused an invitation to join Alexander at a public function. (Navia (2005) and Lane Fox (2004) suggest that this encounter took place in Corinth, rather than Athens.) However, Alexander was so impressed by Diogenes’ insights, and so appalled by the parlous state of his living conditions, that he asked if there was anything he could do for him. In terms familiar to any clinician seeking to ‘help’ a difficult-to-reach patient, the latter replied from his barrel: ‘Yes there is – you can step aside because you are blocking my light.’

This powerful statement of an excluded outsider speaking truth to power (parrhesis) has profound political symbolism and far-reaching philosophical implications. Diogenes’ words, located in his powerlessness and the ‘abjectness’ of his situation (‘all I have and also all that I want to have is the sun in my eyes’), represent a profound challenge to worldly authority as represented by the ‘greatness’ of Alexander. They are rooted in two refusals: first, at the personal level, to be shamed and humiliated by the physical predicament in which he found himself – standing on the only ground he felt he could stand upon; and, second, on ethical grounds, developed into a disciplined, almost ascetic practice (askesis), to accept the laws of his society and any offers made in accordance with those laws. In adhering to this practice, Diogenes had the further aim of provoking reflection upon the limitations of those laws.

This encounter, then, offers a paradigm for a problematised refusal of an offer of accommodation that is both clinical and societal. Diogenes stands for our latter-day socially excluded: the homeless, the truants, the addicted, the antisocial, the borderline and all others who in their ‘un-housed’ states of mind, literally and metaphorically, cannot be accommodated either in the formal structures of the social world or in the minds of its members. However, unlike Diogenes, they cannot metabolise their experience and so cannot articulately express their protest. Standing in relation to these latter-day Diogenes, Alexander comes to represent both the might and the impotence of the system of care and those charged with working within it. The question, then, is what becomes of us as practitioners, or for that matter as citizens, when our authority is disregarded and our invitation is declined? If we stand in Alexander’s shoes, do we follow the impulse to force Diogenes to emerge from his barrel and deal with the dangerous and endangered ‘real world’ on our terms, rather than his? Alternatively, do we wash our hands of him – pass by on the other side and try to take no notice of him, beyond being mindful of our own personal safety, and leave him to freeze to death in a doorway?

Structural violence and the traumatising organisation

Pity would be no more,

If we did not make somebody poor,

And Mercy no more could be

If all were as happy as we.

(Blake, 2002 [1794], p. 77)

The ordinary violence of societal projections into the homeless, the dangerous, the dispossessed and others ‘on the outside’ plays out at the macro as well as at the micro level. Gilligan (1996) describes violence as like a disease within the body politic. Building upon the work of Galtung (1969), Gilligan makes a distinction between structural and behavioural violence. The latter, the interpersonal violence, the dis-ease of the individual, he sees as always taking place in the context of the former: that is, within the formal structures, strictures and expectations of an infected and sick society from which the deviant or the dispossessed are excluded.

Žižek (2008, p. 1) pursues a very similar line in slightly different language, distinguishing ‘subjective’ violence, perpetrated by an identifiable individual, from objective ‘systemic’ violence, which he defines as ‘the often catastrophic consequences of the smooth functioning of our economic and political systems’. For Žižek, systemic violence is the invisible background out of which an act of subjective violence emerges: his point being that if we were more mindful of the systemic violence, if it were more visible, we might be less startled when the subjective violence manifests itself. Subjective violence does not come out of ‘thin air’ – it only appears to.

Like Galtung, Gilligan and Žižek, in their different ways, argue that, societally, we have a need for there to be victims of violence, power differentials and relative deprivation in order that ‘we’ may have a more secure sense of our own well-being in relation to ‘them’ – the dis-eased. This ordinary violence, rooted in the humiliation inherent in the relative poverty of the dispossessed, is then perpetrated in the large groups and communities that we have co-constructed. We can only really then understand the reason for much behavioural and social violence by thinking how humiliating it is for people to live in relative poverty compared to their near neighbours (Charlesworth et al., 2004; Wilkinson and Pickett, 2009; Dorling, 2015 Cooper and Whyte, 2017). The envy and shame born of such profound, yet relative, social disadvantage can be psychologically and emotionally disabling, and the emergent (behavioural) violence is born of the experience of having been, and continuing to be, psycho-socially violated.

I have yet to see a serious act of violence that was not provoked by the experience of feeling shamed and humiliated, disrespected and ridiculed, and that did not represent the attempt to prevent or undo this ‘loss of face’ no matter how severe the punishment.

(Gilligan, 1996, p. 110)

Jordan (1996) addresses the p...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• List of figures
• List of contributors
• Acknowledgements
• Foreword: In and out of the mind
• Introduction
• 1. Housing un-housed minds: Complex multiple exclusion and the cycle of rejection revisited
• 2. ‘There’s no place like home’: On dwelling and Unheimlichkeit
• 3. Beyond the pale: Psychotherapy with people who smell
• 4. Homelessness and containment
• 5. Women: The hidden homeless
• 6. Elective homelessness and the shadow of the institution: Lessons from the lives of survivors of the Irish Industrial School system
• 7. You can take Stig out of the dump, but can you take the dump out of Stig?: The value of consultation to the homelessness organisation
• 8. Homelessness as a psychic solution and defence against breakdown
• 9. ‘Thou should’st not have been old til thou hadst been wise’: Reflections on mental homelessness
• Index